Patient and Caregiver Wellness

Patient Wellness

Loneliness and social isolation are two major wellness issues for seniors in America. Loneliness is the subjective feeling of being alone and social isolation is the objective state of limited social relationships and interactions. While the two issues are similar, they do not always go hand in hand as many seniors are socially isolated yet they do not feel lonely, whereas others are surrounded by friends and family but experience feelings of loneliness. These issues are extremely prevalent in the US, as a 2020 report from the National Academy of Sciences found that 40% of Americans over the age of 65 feel lonely, and over 40% are considered socially isolated. Loneliness and social isolation are particularly problematic in that they increase the risk of premature death, high blood pressure, heart disease, obesity, a weakened immune system, anxiety, depression, cognitive decline, and dementia. In fact, social isolation has been found to increase the risk of dementia by 50%. Moreover, chronic loneliness has been found to have health implications comparable to smoking half a pack of cigarettes per day. 

The most effective way to identify whether loneliness or social isolation is a problem is to have a conversation with the senior and discuss their social life and feelings of loneliness. Understand how frequently they are engaging socially to look for potential social isolation, and ask them how they are feeling about the extent of their social interactions to gauge loneliness. One effective guide for the conversation is the UCLA 3 Items Loneliness Scale, which is used worldwide and allows you to understand the extent of the senior’s loneliness.

Supporting your loved ones is an essential step to prevent loneliness and social isolation. Best practices for family members include: 

• Prioritize communication, and always choose to communicate in person if possible. 
• Encourage your loved ones to participate in social activities at local organizations such as churches or senior centers
• Help your loved one participate in hobbies and social opportunities surrounding their hobby of choice, such as joining a book club or a knitting circle

Moreover, there are plenty of resources available to provide support to seniors suffering from loneliness or social isolation:

• The Institute on Aging’s Friendship Line connects seniors stuck at home to volunteers for social phone calls 
• Papa is a company that connects seniors to college students or families for companionship
• Mental Health America has a peer support community full of people online at all hours looking to interact with and support one another

Unpaid caregiving is becoming a more common practice as more working Americans are finding that their aging loved ones are unable to care for themselves. In fact, 1 in 5 Americans are providing unpaid care to an adult. Moreover, the phenomena of “sandwich caregivers” (caring for one’s children and parents simultaneously) is increasing as the Baby Boomer generation reaches an age in which they require care. About 9 million Americans are sandwich caregivers, and they typically experience this pressure at key points in their careers, thereby adding another layer of stress to their lives. 

While caregivers spend most of their time concerned about the wellness of the senior, their own wellness is often neglected. Caregivers commonly experience burnout, causing them to feel fatigue, stress, anxiety, and depression. Caregiving takes a toll on caregivers’ physical health. One report found that 21% of caregivers feel alone, 21% feel they are in fair or poor health, 23% find it difficult to take care of their own health, and 23% have reported that caregiving has made their health worse. In addition, caregivers face financial strain as 45% caregivers reported experiencing at least one financial impact as a result of caregiving, and 18% report high financial strain as a result of caregiving. The emotional burden of caregiving also takes a toll, as studies have found that senior caregivers experience depression at rates from 26-57%. 

Monitoring caregiver burnout is important, as a caregiver cannot be effective if their own health is poor. Here are some signs of caregiver burnout:

• Irritability
• Emotional and physical exhaustion 
• Changes in sleeping patterns
• Changes in appetite or weight 
• Feelings of hopelessness 
• Lack of pleasure or interest in previously enjoyed activities
• Withdrawal from loved ones 
• Feelings of wanting to hurt yourself or others

Preventing and managing caregiver burnout is essential to provide quality care. Here are some strategies below to manage various areas of caregiver burnout:

Physical 

• Make sure to call your doctor for regular appointments 
• Go for walks or find places to be alone for periods of time to clear your mind 
• Ask others for help, particularly for strenuous movements such as lifting that may be required for your caregiving 
• Eat a healthy and balanced diet 
• Take naps if unable to sleep throughout the night
• Exercise daily, even if only for a few minutes

Financial 

• Create a budget each year, relying on the previous year’s costs to estimate costs for the new year 
• Examine government benefits to see what you or your loved ones may be eligible for

Emotional health  

• Acknowledge and understand your emotions 
• Set realistic goals and boundaries, and accept that you may need help in your caregiving 
• Join a caregiver support group 
• Talk about your feelings with family, friends, or a therapist 
• Ask human resources for caregiving related benefits

Caregiver Wellness